Urological Surgeon University Teaching Hospital Lusaka Zambia
Introduction: The psychosocial impact of Penile cancer treatment generates ripple effect from the patient to his spouse triggering stress, compassion fatigue, and hampering the family’s normal functioning. Fundamental interventions focusing on both the spouse and patients, to improve self-worth and adaptation are generally lacking. Healthcare focus on the patients without regard to the spouses who are generally prone to Vicarious traumatization. The purpose of this study was to assess the impact of a community based resiliency program on the dyadic family care giving congruence and quality of life of post penectomy patients and their spouses.
Methods: 50 dyads participated in a resiliency program in Lusaka, Zambia between February 2021 and August 2021, that involved 4- weekly sessions focused on emotional regulation, self awareness, distress reduction and building resiliency. A Pre- and post-test design using repeated measures was conducted over six months. Each dyad completed a patient and care giver version of the psychometrically validated two-factor Dyadic Relationship Scale (DRS) respectively, to assess negative dyadic strain and positive dyadic interactions. The WHO QoL BREF questionnaire was used to assess the four key domains of physical health, psychological, social relationship and environment, for each member of the dyads. Statistical analyses were performed using IBM SPSS version 23.
Results: Mean age: Spouses and patients; 34.5 ±7.5 and 41.2 ±7 years, respectively. DRS score on Positive Interaction; Spouses pre- and post intervention 12.7 ±1.5 and 23.7 ±0.62, respectively. Patients pre- and post intervention were 13.3 ±1.26 and 23.9 ±0.24, respectively. DRS score on Dyadic Strain; Spouses pre- and post intervention was 19.4 ±0.76 and 6.3 ±1.15, respectively. Mean score pre-intervention was significantly higher than at post intervention (p <0.001). Patients pre- and post intervention was 15.4 ±0.75 and 5 ±0.91, respectively. Mean score pre-intervention was significantly higher than at post intervention (p <0.001). There was significant increase in the QoL scores based on the four domains of the WHO BREF questionnaire, from pre- to post intervention for both spouses and patients (p <0.001).
Conclusions: Psychosocial support for family care dyads as they adapt to post penectomy status can alleviate negative effects on physical and mental health outcomes. Communication improved significantly after the resilient program implying that better reciprocal interactions between spouses can improve coping strategies and quality of life.